Infantino, Florence NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
- Florence J.Infantino Female
Date of Death Age If Veteran of U.S. Armed Forces,
06/30/2018 94 Years War or Dates
Place of Death Hospital, Institution or
- City,Town or Village Albany Street Address Albany Medical Center Hospital
- Manner of Death Natural Cause 0 Accident 0 Homicide 0 Suicide ri Undetermined ri Pending
Circumstances Investigation
• Medical Certifier Name Title
Andrew Marthy
Address
®i 43 New Scotland Ave,Albany,New York 12208
ai Death Certificate Filed District Number Register Number
AA
City, Town or Village Albany 0101 1434
�. ❑Burial Date Cemetery or Crematory
07/03/2018 Pine View Crematory
❑Entombment Address
45®Cremation Queensbury Town ew'ork
Date Place Removed
Removal _ and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destin�.tio+�
Carrier
Disinterment Date Cemetery Address
. . Reinterment Date Cemetery Address
A Li.-` Permit Issued to Registration Number
Name of Funeral Home Alexander Baker Funeral Home 00037
Address
3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
- Remains are Shipped, If Other than Above
Address
1
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/03/2018 Registrar of Vital Statistics Danielle S Gillespie(Electronically Signed)
(signature)
District Number o101 Place Albany, New York
74-1
certify that the remains of the decedent identified above were disposed of in accordancewith this permit on:
Date of Disposition 1)S IR Place of Disposition ?,.V. _ �nw10�---
(address)
r
g (section) t number) (grave number)
Name of Sexton or Person in Charge of Premises i11L stq,Rri'
n (plea a print)
f z
,/./vJ�� Title rr#n -r�
Signature
(over)
DOH-1555 (02/2004)